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Introducing the Journal of Compassionate Health Care

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Sue Shea at University of Crete
Sue Shea
Christos Lionis at University of Crete
Christos Lionis
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E D I T O R I A L Open Access
Introducing the Journal of Compassionate Health
Care
Sue Shea
1,2*
and Christos Lionis
1
The inspiration for this new open access journal, Journal
of Compassionate Health Care emerged from the apparent
need to restore humanity to healthcare, particularly within
a period of austerity that has been affecting many countries.
In 2011, we organized a successful Symposium on the
topic of compassion in health care [1] at the University of
Greenwich, UK, bringing together key people from various
backgrounds with an interest in moving forward with the
science and art of compassion. From this Symposium, we
realized that people are united in the importance of
developing compassionate health care settings, through a
multidisciplinary approach.
This editorial seeks to enhance the broad concept of
compassionate health care, in theory and in practice by
inviting practitioners and researchers in health care to
consider compassionate care as a core subject in their
interest and research priorities. The journal aims to provide
a vehicle for bringing together multidisciplinary per-
spectives, research and initiatives concerning the con-
cept of compassionate health care, which has recently
received much attention and interest. Here we explain
the motivation behind the new open access journal,
and we invite health care practitioners and researchers
to join us in promoting the Journal’saimsandscope.
Compassion in health care
Concerns that health care often fails at a fundamental
level have been recently escalated in the UK since the
publication of the Francis Report [2], which drew inter-
national attention to the lack of the most basic elements
of care. In the US health care systems, similar problems
have also been reported including “escalating costs, medical
errors, inconsistent results and, according to a new national
survey, a lack of compassion”[3]. Evidence suggests that
the component parts of compassion such as kindness,
empathy, attention to basic needs, and attention to dignity,
are crucial in alleviating pain, prompting fast recovery from
acute illness, assisting in the management of chronic illness,
and relieving anxiety. Other physiological benefits of com-
passion have also been reported, for example alteration in
heart rhythm and brain function in both the person
providing and the person receiving compassion [4-6].
For compassion to succeed it is important to consider
the health care setting as a whole, including organizational
factors. Team work, Health Care Professional (HCP) self
care and understanding, and a compassionate approach
between HCPs towards each other may all contribute to
the overall patient and HCP experience. HCPs are often
under strain from large amounts of paperwork and other
factors, and burn-out is a growing issue in general practi-
tioners [7]. Thus if HCPs do not receive adequate support
themselves, it would be more difficult for them to show
compassion towards their patients.
To bring compassion back into the US health care
system, the Schwartz Center for Compassionate Healthcare
(www.theschwartzcenter.org) [8] has developed the Schwartz
Center Rounds®, which are designed for staff to come to-
gether once a month to discuss the non-clinical aspects of
their work, including emotional and social challenges. The
Schwartz Center Rounds are currently being piloted by
the The Point of Care programme in the UK [9].
Compassion may also be viewed as a vehicle for enhan-
cing quality and reducing the cost of health care services.
In times of austerity, as many countries are currently ex-
periencing, health care is deeply affected by cut-backs. The
current economic crisis has seriously impacted health and
welfare care systems [10], but the concept of compassion
has yet to receive the attention that it deserves.
Launching the journal of compassionate health care
With the launch of this new journal, we aim to address
the concepts surrounding the notion of compassion and
we hope that it will contribute to broader discussions of
such within a wider setting. Beyond the fact that compas-
sion is identified as a great virtue, there are many concepts
that are affiliated with it, and among them accountability
* Correspondence: sueshea1@otenet.gr
1
Clinic of Social and Family Medicine, Department of Social Medicine, Faculty
of Medicine, University of Crete, P.O. Box 2208, 71003 Heraklion, Crete
2
Research Consultant, Whitstable, UK
© 2014 Shea and Lionis; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.
Shea and Lionis Journal of Compassionate Health Care 2014, 1:7
http://www.jcompassionatehc.com/content/1/1/7
has been defined as having a central role in applying a
human rights framework to health [11]. Thus, compas-
sion may be seen as incorporating many concepts that
are the focus of current health care systems including
patient safety and rights, quality of health care and cost
of health care services.
There is a rapidly growing interest in the concept of
compassionate care at a global level, although the sub-
ject is still relatively new and developing with regards to
the medical and nursing curricula. Thus, an issue that
introduces some controversy within the subject of
compassionate care is to what extent compassion as a
virtue can be taught. Although most HCPs enter their
profession with compassion, it is possible that the
scientific nature of medical/nurse training may lead to
a decrease in compassion. As such, sustaining compas-
sion as a virtue through support and tuition is a field
requiring prompt attention. Emerging empirical and
observational data suggest that the introduction of
courses on compassionate care within medical and
nurse training is both feasible and welcome [12,13].
Research focusing on the longer term impact of train-
ing in compassionate care and its effects on the well-
being and health outcomes of both patients and HCPs
could be valuable.
The launch contains articles reflecting a wide range
of issues related to compassionate health care. Robin
Youngson [14] describes a workshop which is designed
in accordance to the principles of positive psychology
and appreciative inquiry, and which elicits stories of
deep connection and caring among the participants,
motivating them to strengthen their own caring and
compassion. It is argued that this approach may be
more effective than top-down policies or regulations.
Chapin et al. [15] report on a pilot study which utilises
a compassion meditation intervention for people with
chronic pain. Their work concludes that compassion
meditation may be a useful treatment for reducing pain
severity and anger and for increasing chronic pain accept-
ance. Fitzgerald et al. [16] evaluate a project implementing
the CARE Approach within primary and community care
settings, which aims to enhance empathic, person-centred
communication in health care encounters. These authors
conclude that this approach appears to be useful in pri-
mary and community care, and that it is feasible to deliver
this approach in peer facilitated learning groups.
On behalf of the editors and editorial board members,
welcome to the Journal of Compassionate Health Care.
In conclusion, we look forward to promoting discussion,
research and activities across the broad and diverse field
of compassionate health care.
Received: 19 September 2014 Accepted: 19 September 2014
References
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doi:10.1186/s40639-014-0007-7
Cite this article as: Shea and Lionis: Introducing the Journal of
Compassionate Health Care. Journal of Compassionate Health Care
2014 1:7.
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Shea and Lionis Journal of Compassionate Health Care 2014, 1:7 Page 2 of 2
http://www.jcompassionatehc.com/content/1/1/7
... Compassion and Respectful Care (CRC) are at the heart of radiology's professional policy and practice, and they align with the National Health Service (NHS) Constitution's core values [1] . As defined by scholars, compassion is the intelligent kindness and powerful emotional sensitivity to recognize and understand human misery, which requires a personal experience of others' suffering and is displayed in practical caring for them in a way that relieves the sufferer [2][3][4] . Respectful care is described as the kind of dignified care provided in any setting, irrespective of gender, age, personality, economic status, lifestyle culture, or race, which supports and promotes and does not undermine a person's self-respect [5] . ...
... There could be a difference in time, study design, study participants, or measuring methods, which could account for the discrepancy. In addition, the finding of this study was higher than those of a study conducted in Northeast Ethiopia (51.55%) (8), public hospitals of Addis Ababa (48%) [26] , and Tigray Region (55%) [4] . The variation might be due to the difference in measurement tools, study area, time of the study, [27] . ...
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... This finding is in line with the study conducted in West Ethiopia which revealed 39.3% of women had the right information regarding services given in health facilities that helped them to get respectful care [11]. The possible justification for this could be women who had frequent visits to health facilities and discussed maternity issues were more likely to be familiar with service providers and this can significantly enhance RMC service [28,29]. ...
Determinants of respectful maternity care among women who gave childbirth in Southern Ethiopia
Article
Full-text available
  • Apr 2024
  • BMC HEALTH SERV RES
Background Having a good provision of respectful maternity care (RMC) to a woman who gives childbirth is a crucial component of maternal health care to result in positive maternal and neonatal outcomes. Disrespect and lack of women-centered care in birth discourage a woman from seeking healthcare during childbirth contributing to poor healthcare-seeking behaviour and dissatisfaction with the maternity service. The current study aimed to assess key determinants of RMC during childbirth at selected public health facilities of the Gofa zone, Southern Ethiopia. Methods A cross-sectional study design was conducted from March to April 2021 among 390 women who gave birth in eight randomly selected public health facilities of Gofa zone, Southern Ethiopia. The level of RMC was measured using structured exit interview items. A structured-interviewer-administered questionnaire was used to collect data and then entered into Epi-data version 4.6 and exported to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were used to identify determinants of RMC among women. Results A total of 390 women responded to the exit interview making a response rate of 100%. The mean (± SD) age of the 390 women was 27.9 (± 4.85) years. The overall prevalence of women who received RMC was 40.5%, 95% CI (36-45%). Two hundred and ninety-seven (76.2%; n = 297/390) women had antenatal care (ANC) attendance in the index pregnancy. A woman who had planned pregnancy (AOR = 1.72, CI: 1.04, 2.85), planned to deliver in a health facility (AOR = 1.68, CI: 1.00, 2.81), presence of familial support (AOR = 2.04, CI: 1.20, 3.48), and had information about service availability (AOR = 4.44, CI: 2.09, 9.42) were associated with RMC among women. Conclusion The provision of respectful maternity care in the study area was low when compared with local studies. Planned pregnancy, plan to deliver in a health facility, family support, and presence of information about service availability were factors associated with RMC among women. More attention should be given to training and supportive supervision of health care professionals on respectful maternity care and its standards to increase service uptake and make service more women-centred.
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... widely acknowledged that CRC training is vital for gearing up MNHC providers to offer human-centered care, serve patients ethically and with respect, keep taking a professional oath, and promote providers to provide clients with satisfactory service quality [20,59,61]. Besides that, the training may influence HCPs' knowledge, motivation, and attitude toward the RMC, which will have a significant positive impact on its provision. ...
The prevalence of respectful maternity care during childbirth and its determinants in Ethiopia: A systematic review and meta- analysis
Article
Full-text available
Background Respectful maternity care is the provision of woman-centered health care during childbirth that is friendly, abuse-free, timely, and discrimination-free. Although several epidemiological studies on the magnitude and determinants of Respectful maternity care in Ethiopia have been conducted, the results have been inconsistent and varied. This makes drawing equivocal conclusions and evidence at the national level harder. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of respectful maternity care and its determinants in Ethiopia. Methods Studies conducted from 2013 to June 30, 2022, were searched by using PubMed, Google Scholar, Science Direct, Scopus, ProQuest, Web of Science, Cochrane Library, and Direct Open Access Journals. Searching was carried out from May 15- June 30, 2022. In total, sixteen studies were considered in the final analysis. The data were extracted using Microsoft Excel and analyzed using STATA 16 software. The methodological quality of included studies was assessed by using Joanna Briggs Institute’s critical appraisal checklist for prevalence studies. To estimate the pooled national prevalence of respectful maternity care, a random effect model with a DerSimonian Laird method was used. To assess the heterogeneity of the included studies, the Cochrane Q test statistics and I2 tests were used. To detect the presence of publication bias, a funnel plot and Begg’s and Egger’s tests were used. Results: Sixteen studies were eligible for this systematic review and meta-analysis with a total of 6354 study participants. The overall pooled prevalence of respectful maternity care in Ethiopia was 48.44% (95% CI: 39.02–57.87). Receiving service by CRC-trained health care providers [AOR: 4.09, 95% CI: 1.73, 6.44], having ANC visits [AOR: 2.34, 95% CI: 1.62, 3.06], planning status of the pregnancy [AOR = 4.43, 95% CI: 2.74, 6.12], giving birth during the daytime [AOR: 2.61, 95% CI: 1.92, 3.31], and experiencing an obstetric complication [AOR: 0.46, 95% CI: 0.30, 0.61] were identified as determinants of RMC. Conclusion: As per this meta-analysis, the prevalence of respectful maternity care in Ethiopia was low. Managers in the health sector should give due emphasis to the provision of Compassionate, Respectful, and Care(CRC) training for healthcare providers, who work at maternity service delivery points. Stakeholders need to work to increase the uptake of prenatal care to improve client-provider relationships across a continuum of care. Human resource managers should assign an adequate number of health care providers to the night-shift duties to reduce the workload on obstetric providers.
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... Communication and interpersonal skills training work well for younger physicians. Lack of visible support from the CED, and from other senior leaders was also raised as a major barrier to implement compassionate healthcare practice [2]. In the same, another study which was carried out in London, England viewed that clinical staff lacked sufficient time to demonstrate a compassionate approach, and it was generally agreed that strong leadership was required to ensure a consistent compassionate approach from all staff within a healthcare organization [3]. ...
IMPORTANCE OF IN-SERVICE TRAINING ON IMPLEMENTATION OF COMPAS- SIONATE AND RESPECTFUL CARE DELIVERY IN GONDAR METROPOLITAN CITY GOVERNMENTAL HEALTH FACILITIES: NORTHWEST ETHIOPIA
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Full-text available
  • Mar 2022
Background: Nowadays, compassion and respectful care (CRC) is not an optional, but it is a professional mandatory. However , the health work force frequently considered it as it is less important as other aspects of care. A study which was conducted in Canada showed that compassion is broadly considered as a cornerstone of quality health care delivery.
View
... It is widely recognized that compassionate and respectful care training is crucial to capacitate MNHC providers to offer human-centered care, serve patients ethically with respect, remember to adhere to a professional oath, and encourage providers to deliver acceptable service quality to the clients. 45,46 Similarly, the current study indicated that receiving labor delivery care from CRC-trained providers increases the odds of getting RMC by fourfolds. A similar association was also noted in the previous studies. ...
Respectful maternity care among laboring women in public hospitals of Benishangul Gumuz Region, Ethiopia: A mixed cross-sectional study with direct observations
Article
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  • Feb 2022
Objectives Promoting respectful maternity care is a fundamental strategy for enhancing facility birth, which significantly reduces maternal and newborn mortality and morbidity. Despite these effects, disrespect and abusive childbirth care remain a challenge in Ethiopia. Therefore, this study aimed to determine the prevalence of respectful maternity care and its associated factors among laboring women in public hospitals of Benishangul Gumuz region, Ethiopia. Methods A facility-based cross-sectional study design was employed, and trained external assessors observed the care provided to 404 laboring women in public hospitals using structured observation checklists. A focus group discussion and two key informant interviews were also conducted. A structured pre-tested questionnaire and a semi-structured guide were used to generate quantitative and qualitative data, respectively. Seven verification criteria were employed, and the mean value and above for each criterion were used to measure respectful maternity care. Results Of the 404 client–provider interaction observations during childbirth, only 12.6% ( n = 51) participants received respectful maternity care. Being from an urban area (adjusted odds ratio = 3.34, 95% confidence interval: 1.39, 8.08), giving childbirth at daytime (adjusted odds ratio = 2.59, 95% confidence interval: 1.26, 5.33), receiving the service from compassionate and respectful care trained provider (adjusted odds ratio = 4.54, 95% confidence interval: 1.63, 12.66), giving childbirth at general hospital (adjusted odds ratio = 3.03, 95% confidence interval: 1.39, 6.65) were positively associated with respectful maternity care. Staff workload, shortage of supply and equipment, partiality in providing timely care, yelling and insulting at clients and birth companions were also barriers to respectful maternity care. Conclusion The observed respectful maternity care practices were low in the study area. Therefore, the findings of this study suggest that addressing respectful maternity care would require increased compassionate and respectful care trained providers, and sustained efforts to improve access to basic equipment and supply for maternity care with an emphasis on primary hospitals. Tailored interventions aimed at improving respectful maternity care should also target rural residents and nighttime parturients.
View
... It is widely recognized that compassionate and respectful care training is crucial to capacitate MNHC providers to offer human-centered care, serve patients ethically with respect, remember to adhere to a professional oath, and encourage providers to deliver acceptable service quality to the clients. 45,46 Similarly, the current study indicated that receiving labor delivery care from CRC-trained providers increases the odds of getting RMC by fourfolds. A similar association was also noted in the previous studies. ...
Respectful maternity care among laboring women in public hospitals of Benishangul Gumuz Region, Ethiopia: A mixed crosssectional study with direct observations
Article
Full-text available
  • Feb 2022
Promoting respectful maternity care is a fundamental strategy for enhancing facility birth, which significantly reduces maternal and newborn mortality and morbidity. Despite these effects, disrespect and abusive childbirth care remain a challenge in Ethiopia. Therefore, this study aimed to determine the prevalence of respectful maternity care and its associated factors among laboring women in public hospitals of Benishangul Gumuz region, Ethiopia.
View
... Compassionate and compassionate related care has resulted in alleviating pain, promoting fast recovery from acute illness, assisting in the management of chronic illness, relieving anxiety, and better resource management and reducing costs. Compassionate care also has physiological benefits such as altering heart rhythm [3][4][5][6][7]. ...
Validity and reliability of the Amharic version of the Schwartz Center Compassionate Care Scale
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Background Compassionate care is the sensitivity shown by health care providers to understand another person’s suffering and a willingness to help and to promote the well being of that person. Although monitoring of compassionate care is key to ensuring patient-centered care, there is no validated tool in the Ethiopian context that can be applied to measure compassionate care. Therefore, this study aimed to assess the structural validity and reliability of the 12-item Schwartz Center Compassionate Care Scale ® (SCCCS) in the Ethiopian context. Methods The structural validity and reliability of the 12-item Schwartz Center Compassionate Care Scale ® were investigated in a sample of 423 oncology patients in the adult Oncology department of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The internal consistency of the instrument was examined based on Cronbach’s alpha coefficient, and the structural validity was evaluated by subjecting the items of the instrument to factor analysis. Statistical analysis was made using SPSS version 23.0. Results We have found that the Schwartz Center Compassionate Care scale is a two-factor structure (recognizing suffering and acting to relieve suffering). The scale has high overall scale reliability, which was 0.88, and subscale reliability of 0.84 for both recognizing suffering and acting to relieve suffering factors. Conclusions The Schwartz Center Compassionate Care Scale has high internal consistency and acceptable structural validity value. The tool can be used to measure compassionate care practice in the Ethiopian context.
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“Sharing in people's pain is not an easy thing to do”: Cognitive Behavioural Therapists' understandings of compassion in the workplace
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  • Jan 2023
Compassion is central to the aim of improving patient care and staff well‐being within healthcare systems. To inform service development, explorations of experiences and meanings of compassion are needed. This study explored cognitive behavioural therapists' understandings of compassion within their work environment. A qualitative study was conducted using semistructured interviews and interpretative phenomenological analysis (IPA). Data were obtained from five practicing cognitive behavioural therapists. Two superordinate themes were developed, each with two subordinate themes. CBT therapists reported entering the profession with intrinsic motivation to care for others. They further developed an interest in compassion with exposure to clients and ongoing professional development in compassion‐focused therapy (CFT). Compassionate work environments helped to facilitate compassionate practice; however, for many, workplaces were perceived to lack compassion. Challenges were encountered when negative workplace interactions left therapists feeling fatigued, distressed and demoralised. There was a desire for recognition and to be seen as more than a “work machine,” the experience of which was a threat to retaining therapists within the profession. Current recruitment and training processes are producing staff with skills and motivation to deliver compassionate care. However, lack of compassion within workplaces can be a barrier to actioning these skills and motivations. Research needs to focus on how to effectively implement and run systems that are compassionate for both staff and clients. To provide compassionate care, staff need work environments that show compassion to them. These findings provide some insights into and practical suggestions regarding how this can be achieved.
View
Evaluation of compassionate and respectful care implementation status in model healthcare facilities: a cross-sectional study
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Background Compassionate respectful, and caring (CRC) creates a pleasant environment for health workforce (HWF), customers, and families. For the past five years, the Ethiopian Ministry of Health (EMoH) has developed a CRC plan to improve person-centered care. Therefore, we aimed to assess the implementation status of CRC and associated factors in the 16 model health facilities (MHFs) in Ethiopia. Methods A cross-sectional study was employed from February to April 2021. A structured and semi-structured questionnaire was used to assess the level of CRC implementation in model health care facilities. Epi-data version 4.3 and SPSS version 26 software were used for data entry and analysis, respectively. Binary logistic regressions analysis was used and significance was obtained at the odds ratio with a 95% confidence interval and P -value < 0.05. Results A total of 429 HWF participated in a self-administered questionnaire. The prevalence of compassionate and respectful care among HWF were 60.4%, and 64% respectively. Nurse professionals, midwives, having training on CRC, leader promoting CRC, having a conducive working environment and burnout management for HWF were significantly associated with compassionate care practice. Leaders promoting CRC, having a conducive working environment, and burnout management for HWF were significantly associated with respectful care practice. Conclusion The findings identified distinct issues related to CRC implementation in each 16 MHF. Addressing HWF skill gaps, a conducive working environment, and burnout management are encouraged CRC continuity. Incorporate CRC in pre-service education, health system strengthening, and motivating HWF are important for CRC strategic implementation.
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The importance of compassion and respectful care for the health workforce: a mixed-methods study
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Full-text available
  • Mar 2021
  • J Publ Health
Background Compassionate and respectful care (CRC) is an essential element for health care providers (HCPs), which builds a positive environment and intimacy among health care professionals, patients, and families. However, there is a lack of studies examining the prevalence of and factors associated with compassionate and respectful care practice in low-resource countries. Therefore, this study aimed to assess the practice of compassionate and respectful care and its associated factors among the health workforce (HWF).Methods This mixed-methods study was conducted through quantitative and qualitative data collection from April to May 2019 in North Shewa Zone health care facilities (NSHFs). For quantitative analysis, participants were selected using a systematic random sampling technique. Participants for qualitative analysis were selected using a purposive sampling technique. Data entries were made by EpiData version 3.2 and exported to SPSS version 23 software for analysis. Bivariable and multivariable logistic regression analyses were performed to determine the associated factors. Thematic analysis was carried out for qualitative data.ResultsA total of 392 HWF responded to a self-administered survey, and 72 participants participated in focus group discussions (FGDs). Four categories of themes emerged: definition/knowledge, barriers, benefit, and leadership will. The prevalence of compassionate and respectful care practices was 38.8% and 46.2%, respectively. Female gender, health officer role, having a monthly salary equal to or greater than 5000 Ethiopian birr, and a positive attitude were significantly associated with compassionate care practice. The age category of 30–39, positive attitude, and ensuring a safe and clean care environment were significantly associated with respectful care practice.Conclusion Compassionate and respectful care among HWF requires an actual demonstration of humanity and kindness to promote person-centered practice for their clients. Therefore, the Ethiopian Federal Ministry of Health should emphasize CRC continuity by including it in the health care curriculum, improving the health care ethics skill gap, designing appropriate policy to reduce workload, and promoting patient rights.
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Re-inspiring compassionate caring: the reawakening purpose workshop
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Full-text available
  • Oct 2014
How best to strengthen compassion in healthcare has become a controversial subject, especially when governments attempt to ‘implement’ compassion through policy and regulation. This case study describes a workshop, designed according to principles of appreciative inquiry, which elicits stories of deep connection and caring, and uncovers the hidden strengths of the workshop participants. This re-connection to purposes generates positive energy and motivates people to strengthen their own caring and compassion. Participants are reminded of the values, hopes and aspirations that brought them into healthcare. Experience with this ‘Reawakening Purpose’ workshop in the UK, the USA, Australia and New Zealand shows it to be a transformative process for health professionals, even for those suffering from stress or burnout. It can be completed in 60 to 90 minutes and so is easily fitted into the working day. This workshop is a key process for inducting followers into an international social movement for compassionate, human-centred healthcare: ‘Hearts in Healthcare’. It’s argued that this grassroots approach to strengthening compassion may be much more effective than any top-down policy or regulation.
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Pilot study of a compassion meditation intervention in chronic pain
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The emergence of anger as an important predictor of chronic pain outcomes suggests that treatments that target anger may be particularly useful within the context of chronic pain. Eastern traditions prescribe compassion cultivation to treat persistent anger. Compassion cultivation has been shown to influence emotional processing and reduce negativity bias in the contexts of emotional and physical discomfort, thus suggesting it may be beneficial as a dual treatment for pain and anger. Our objective was to conduct a pilot study of a 9-week group compassion cultivation intervention in chronic pain to examine its effect on pain severity, anger, pain acceptance and pain-related interference. We also aimed to describe observer ratings provided by patients’ significant others and secondary effects of the intervention. Pilot clinical trial with repeated measures design that included a within-subjects wait-list control period. Twelve chronic pain patients completed the intervention (F = 10). Data were collected from patients at enrollment, treatment baseline and post-treatment; participant significant others contributed data at the enrollment and post-treatment time points. In this predominantly female sample, patients had significantly reduced pain severity and anger and increased pain acceptance at post-treatment compared to treatment baseline. Significant other qualitative data corroborated patient reports for reductions in pain severity and anger. Compassion meditation may be a useful adjunctive treatment for reducing pain severity and anger, and for increasing chronic pain acceptance. Patient reported reductions in anger were corroborated by their significant others. The significant other corroborations offer a novel contribution to the literature and highlight the observable emotional and behavioral changes in the patient participants that occurred following the compassion intervention. Future studies may further examine how anger reductions impact relationships with self and others within the context of chronic pain.
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Enhancing empathy in healthcare: mixed-method evaluation of a pilot project implementing the CARE Approach in primary and community care settings in Scotland
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Full-text available
  • Oct 2014
The importance of empathic, person-centred care that is responsive to the individual patients’ needs is increasingly visible in national and international healthcare policies but there is a need for practical tools to help healthcare practitioners. The CARE Approach is a new ‘generic’ learning tool that aims to foster the achievement of empathic, person-centred communication in healthcare encounters. This study aimed to evaluate a pilot project which used the CARE Approach in peer facilitated groups in primary and community healthcare settings in Scotland. The CARE Approach was piloted in 5 sites (4 general practice and 1 community rehabilitation team) serving different areas and populations. Evaluation employed a mixed-methods approach, with questionnaires and semi-structured interviews with a purposive sample of participating facilitators and healthcare practitioners. 131 practitioners took part in the CARE Approach pilot across the five sites. 84 participants (64.1%) completed a baseline questionnaire and 51 (38.9%) a post-pilot questionnaire. Semi-structured interviews were conducted with all facilitators and with a purposive sample of 23 participants from the sites. Overall the results indicate that the CARE Approach was perceived as useful and relevant to practice across different disciplines and settings. The flexibility of the CARE Approach materials facilitated its delivery and implementation across the sites. Healthcare professionals’ self-perceived empathy at baseline and follow-up suggested a possible impact on daily practice. The CARE Approach appears to be useful to practitioners in primary and community care and can feasibly be delivered in peer facilitated learning groups. Further work is required to determine the utility of the approach when used in other ways and in other settings and to ascertain the effectiveness of the approach in the longer-term.
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Compassion in the nursing curriculum: making it more explicit
Article
Full-text available
  • Dec 2011
The meaning and definition of compassionate care continues to be discussed and debated, as does how it can be measured and whether it can be taught (Bradshaw 2009; Shea and Lionis 2010; Dewar et al. 2011). Nurse educators are faced with this challenge as they plan, develop and deliver a curriculum that seeks to equip nurses and midwives with the knowledge and skills required to practice compassionate care. But how can we teach our students compassionate care? Although compassion and caring are included within the nursing curriculum it has been suggested that these aspects of care take a far less prominent position than do technical components (Firth-Cozens & Cornwell 2009; Shea & Lionis 2010). At Edinburgh Napier University’s Leadership in Compassionate Care Programme (LCCP), the further embedding of compassionate care into the nursing and midwifery programme is a priority. This paper describes an LCCP action research project aimed at enhancing, and making more explicit, students’ learning about compassionate care when nursing patients during acute stages of illness.
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Introducing and implementing a compassionate care elective for medical students in Crete
Article
Full-text available
  • Dec 2011
Many reports have commented on the decreasing level of humanity in healthcare, and that medical training has an increasingly scientific basis. This paper reports on a six-week elective on compassionate care, delivered to first year medical students at the University of Crete Medical School.The course proved highly popular, and may represent a starting point for emphasising the importance of compassionate care in the Greek healthcare system.
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Time, Touch, and Compassion: Effects on Autonomic Nervous System and Well-Being
Article
Full-text available
  • May 2012
Compassion is critical for complementary and conventional care, but little is known about its direct physiologic effects. This study tested the feasibility of delivering two lengths of time (10 and 20 minutes) and two strategies (tactile and nontactile) for a practitioner to nonverbally communicate compassion to subjects who were blind to the interventions. Healthy volunteers were informed that we were testing the effects of time and touch on the autonomic nervous system. Each subject underwent five sequential study periods in one study session: (1) warm-up; (2) control-with the practitioner while both read neutral material; (3) rest; (4) intervention-with practitioner meditating on loving-kindness toward the subject; and (5) rest. Subjects were randomized to receive one of four interventions: (1) 10 minutes tactile; (2) 20 minutes tactile; (3) 10 minutes nontactile; or (4) 20 minutes nontactile. During all interventions, the practitioner meditated on loving-kindness toward the subject. For tactile interventions, the practitioner touched subjects on arms, legs, and hands; for nontactile interventions, the practitioner pretended to read. Subjects' autonomic activity, including heart rate, was measured continuously. Subjects completed visual analog scales for well-being, including relaxation and peacefulness, at warm-up; postcontrol; immediately postintervention; and after the postintervention rest and were asked about what they and the practitioner had done during each study period. The 20 subjects' mean age was 24.3 ± 4 years; 16 were women. The practitioner maintained a meditative state during all interventions as reflected in lower respiratory rate, and subjects remained blind to the practitioner's meditative activity. Overall, interventions significantly decreased heart rate (P < .01), and although other changes did not reach statistical significance, they were in the expected direction, with generally greater effects for the tactile than nontactile strategies and for 20-minute than 10-minute doses. Two strategies are feasible for blinding subjects to nonverbal communication of compassion; even with blinding, nonverbal communication of compassion affects subjects' autonomic nervous system. These results should be replicated in larger samples, including patient populations, and mechanisms sought to explain observed effects. Compassion is not only good care; it may also be good medicine.
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Supporting hospital staff to provide compassionate care: Do Schwartz Center Rounds work in English hospitals?
Article
Full-text available
  • Mar 2012
  • J ROY SOC MED
To assess (1) whether the Schwartz Center Rounds ("Rounds"), a multidisciplinary forum which brings together hospital staff to discuss the nonclinical, social and emotional aspects of caring for patients, could transfer from the US to a UK setting; and (2) whether UK Rounds would achieve a similar positive impact on individuals and teams, and hospital culture. The results reported are based on 41 qualitative interviews with context provided by additional quantitative research. We introduced Rounds at two pilot sites, both NHS hospitals providing acute care. Over the one-year, ten-Rounds pilot period, Rounds were attended by 1250 staff across the two sites. We conducted qualitative research into the experiences of staff involved in implementing Rounds at the outset and the end of the pilot. Interviewees' assessment of the effects of Rounds on participants, their relationships with colleagues, and the wider hospital. The findings show that in the two pilot trusts, Rounds are perceived by participants as a source of support and that their benefit may translate into benefits for patients and team working; and that Rounds have the potential to effect change in the hospital culture. Rounds appear to transfer successfully from the US to the UK, and there is some evidence that they are having a similarly positive impact, but more research is needed.
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Reaching a consensus in defining and moving forward with the science and art of compassion in healthcare
Article
  • Jan 2011
Distressing media reports often remind us of the lack of sensitivity and humanity in healthcare. However, many healthcare professionals believe in restoring compassion to care, and are keen to identify ways of achieving this. This report is a brief summary of a symposium (Greenwich University, June 201) with the aim of discussing compassionate care and sharing ideas and experiences. The event was a success, generating enthusiasm and continuing communication between participants.
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